Case Report: Sublingual Microcirculatory Alterations in a Covid-19 Patient With Subcutaneous Emphysema, Venous Thrombosis, and Pneumomediastinum.

The Corona virus disease 2019 (Covid-19) has brought a wide range of challenges in intensive care medicine. Understanding of the pathophysiology of Covid-19 relies on interpreting of its impact on the vascular, particularly microcirculatory system. Herein we report on the first use of the latest generation hand-held vital microscope to evaluate the sublingual microcirculation in a Covid-19 patient with subcutaneous emphysema, venous thrombosis and pneumomediastinum. Remarkably, microcirculatory parameters of the patient were increased during the exacerbation period, which is not a usual finding in critically ill patients mostly presenting with a loss of hemodynamic coherence. In contrast, recovery from the disease led to a subsequent amelioration of these parameters. This report clearly shows the importance of microcirculatory monitoring for evaluating the course and the adequacy of therapy in Covid-19 patients.

Informations de copyright

Copyright © 2021 Grewal, Harjo, Aykut, Ergin, Nowitzky, Ince and Akin.

Déclaration de conflit d'intérêts

CI has developed SDF imaging and is listed as an inventor on related patents that were commercialized by Micro Vision Medical (MVM) under a license from the Academic Medical Center (AMC). He receives no royalties or benefits from this license. He has been a consultant for MVM in the past but has not been involved with this company for more than five years and holds no shares or stock. Braedius Medical, which is a company that is owned by a relative of CI, has developed and designed a handheld microscope, namely, the CytoCam-IDF imaging microscope. The images used in the present study were obtained using this technology. CI has no financial relationship with Braedius Medical of any sort. He has never owned shares or received consultancy or speaker fees from this company. MicroTools software that was used for analysis of the images is being developed by CI and Dr. Mathias Hilty and owned by Active Medical BV Leiden, The Netherlands. Active Medical also runs an internet site called microcirculationacademy.org which offers educational courses and services that are related to clinical microcirculation. CI discloses that he is a shareholder of this company. The remaining authors declare that they do not have any commercial or financial relationships that could be construed as a potential conflict of interest.